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Could leg pain be PAD?

Luis Suarez, MD is a vascular surgeon at Tufts Medical Center in Boston.While coronary artery disease is the most common type of heart disease and the leading cause of death in the United States, a vascular condition known as Peripheral Artery Disease (PAD) affects more than 10 million Americans.  It is more common among those 65 or older but can occur at nearly any age. To minimize risks and optimize care, we asked Luis Suarez, MD from the Vascular Surgery Division at Tufts Medical Center, some common questions about PAD. 

What is PAD?

PAD is a chronic disease in which plaque (fatty deposits) builds up in the arteries that supply blood to the legs. If allowed to progress, blood vessels will narrow, blood flow will become restricted or blocked, and complications will arise. In addition to hardening of the arteries (atherosclerosis), less common causes of PAD are blood clots and injuries to limbs. 

How serious is this condition?

Undiagnosed and untreated, PAD can be dangerous, often resulting in leg pain, painful foot ulcers, infections, and gangrene, which could lead to poor quality of life and even the loss of a leg. Every year, there are approximately 200,000 leg amputations in the United States, many of which can be avoided with proper treatment.

What are the symptoms of PAD?

Half of the people with PAD don’t know they have it because they have no symptoms or they go misdiagnosed as symptoms are unspecific. However, possible symptoms include pain in the calves and thighs with walking, numbness in the legs, foot pain that worsens at night and improves when dangling the leg, foot ulcers, and hair loss on the legs.

What are the risks?

Risk factors that contribute to PAD include smoking, diabetes, obesity, high blood pressure and cholesterol, increased age, kidney failure, and family history of heart disease. PAD is also a major risk factor for heart attacks and stroke. Addressing these risk factors will allow patients to delay or prevent PAD.

How is PAD diagnosed?

If you have any of the above symptoms or risk factors, you should consult as soon as possible with your primary care physician, who might refer you to a vascular specialist for testing. The most common test for PAD is the “ankle-brachial index,” which compares the blood pressure in the ankle with that in the arm. Other diagnostic imaging includes ultrasound scanning, CT scans, MRI’s (which don’t involve X-rays), and angiography (X-rays combined with the injection of a contrast agent).   

What are the treatment options?

Non-surgical treatments include smoking cessation, supervised exercise programs, diet adjustments, and medication. If these interventions aren’t sufficient, minimally invasive procedures, with no incisions and quick recovery, include angioplasty and stenting (to unblock or repair blood vessels). More advanced cases of PAD may require the surgeon to perform open surgery in the form of lower extremity revascularization (bypass surgery), or endarectomy (the removal of the inner lining of an artery).  In addition, new studies and clinical trials involving stem cell therapy may provide other promising alternatives in the future. Of course, all patients are different, and treatment plans must be customized.

To make an appointment with a vascular specialist, call 844-543-3145.